Background: Lung cancer is a top priority area for the Georgia Cancer Coalition, for the National Cancer Institute (NCI), for the Department of Veterans Affairs (VA), for the National Center for primary care (NCPC) at the Morehouse School of Medicine (MSM), and for other health organizations such as the American Cancer Society (1). Lung cancer remains the number one cause of cancer mortality nationwide in both males and females, and it is the primary cancer in terms of both incidence and mortality in the Atlanta VA Network and throughout the South East. Although early detection and surgical resection is the best and perhaps the only current hope for cure, with average five-year survival rates greater than 70%, the main problem is that only 25% of our patients are diagnosed with stage I lung cancer. Specific Aims: 1. Determine whether "targeted" screening is indeed associated with an increased proportion of lung cancers diagnosed at stage I. 2. Determine the costs associated with "targeted" screening for lung cancer in the Atlanta VA Network and the Grady Health System. 3. Determine the costs associated with "usual" detection of lung cancer in the Atlanta VA Network and the Grady Health System. 4. Assess preferences of smokers and patients with lung cancer with regards to screening and potential treatment outcomes. 5. Perform a cost-effectiveness analysis of the costs of "targeted" screening versus "usual" detection of lung cancer, and the outcomes for quality-adjusted stage of disease.